The present study examines the influence of language proficiency and language combination on bilingual lexical access using category fluency in 109 healthy speakers. Participants completed a category fluency task in each of their languages in three main categories (animals, clothing, and food), each with two subcategories, as well as a language use questionnaire assessing their proficiency. Five language combinations were examined (Hindi–English, Kannada–English, Mandarin–English, Spanish–English, and Turkish–English). Multivariate analyses of variance revealed that the average number of correct items named in the category fluency task across the three main categories varied across the different groups only in English and not the other language. Further, results showed that language exposure composite (extracted from the questionnaire using a principal component analysis) significantly affected the average number of items named across the three main categories. Overall, these results demonstrate the effects of particular language combinations on bilingual lexical access and provide important insights into the role of proficiency on access.